• Associate Actuary

    Humana (Albany, NY)
    …responsible for estimates of short term and long term reserves required for unpaid claim liability, active life reserves, and other actuarial items that ought to be ... Actuary, Valuation is responsible for estimates of reserves required for unpaid claim liability, including incurred but not reported (IBNR) reserves for all Humana… more
    Humana (11/14/25)
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  • Integrated Absence Specialist

    Kaleida Health (Buffalo, NY)
    …guiding EEs through the process, maintaining ADA records and following up with ADA claim closures as needed. Coordinates the leave of absence and return to work of ... managers in identifying transitional return to work opportunities. Works closely with claim administrators in tracking and minimizing lost time. Serves as a Human… more
    Kaleida Health (10/23/25)
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  • Sr. Provider Reimbursement Professional Certified…

    Humana (Albany, NY)
    …certification from the AAPC and/or AHIMA) + Extensive knowledge of medical claims processing and familiarity with reimbursement methodologies, ICD, CPT, and HCPCS + ... field + Knowledge of internal Medical Coverage Policies and Claims Payment Policies + CAS claims processing...protect member PHI / HIPAA information **Additional Information** + Hours : Monday-Friday with a start time between the … more
    Humana (11/21/25)
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  • Medical Coding Auditor Evaluation & Management

    Humana (Albany, NY)
    …and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are ... your skills to make an impact** **WORK STYLE:** Remote/Work at home **WORK HOURS :** Associates will work on EST, regardless of where the associate resides. Work… more
    Humana (11/18/25)
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  • Patient Account Assoc I Credit Balances

    Intermountain Health (Albany, NY)
    …an overall goal of account resolution. + Abel to navigate various payer claim portals and understand payer functionality. + Interacting with others by effectively ... English. **Skills** + Recognizing true overpayments from false credits + Researching claim cycle + Understanding Coordination of Benefits + Understanding EOB +… more
    Intermountain Health (11/27/25)
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  • Senior Certified Professional Coder, Special…

    CVS Health (Albany, NY)
    …and every day. The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with ... complex issues with sensitivity. Including but not limited to claim reviews for legal, compliance or rework projects. +...(CPC) + GED or High School diploma **Anticipated Weekly Hours ** 40 **Time Type** Full time **Pay Range** The… more
    CVS Health (11/25/25)
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  • Senior Eligibility Consultant

    CVS Health (Amherst, NY)
    …and timely policy and eligibility data utilizing administration systems for claim payment purposes and product production ensuring services and products meet ... issues + Partner directly with clients, vendors, internal teams, and/or local claim operation to resolve problems and achieve positive outcomes + Anticipate and… more
    CVS Health (11/20/25)
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  • Pharmacy Contracting Professional 2

    Humana (Albany, NY)
    …2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives, ... 2 ensures contract compliance and performs analysis regarding pharmacy claims . Understands department, segment, and organizational strategy and operating objectives,… more
    Humana (11/21/25)
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  • Resources & Reimbursement Agent 1/Trainee 1&2 (NYS…

    New York State Civil Service (Albany, NY)
    …Appointment Type Permanent Jurisdictional Class Competitive Class Travel Percentage 0% Workweek Mon-Fri Hours Per Week 37.5 Workday From 8 AM To 5 PM Flextime ... reviews and evaluations, determining payment sources, and developing and submitting claims for health care and treatment costs.*Trainee 2 ($59,994): Five years… more
    New York State Civil Service (11/21/25)
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  • Principal, Stars Enterprise Activation - Insurance…

    Humana (Albany, NY)
    …encompasses critical functions including care coordination, quality measurement, billing, claims processing, and customer service, each essential to delivering a ... operational knowledge of core functional areas (care coordination, quality, billing, claims , and customer service). + Collaborate with each Insurance Operations… more
    Humana (11/19/25)
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